Retrospective Analysis Of 32 Cases Of Severe Drug Eruption

Objective:To explore the clinical features,treatment and prognosis of Severe drug eruption.It provides a useful reference for clinical work.Method:The clinical data of 32 Severe drug eruption patients admitted to the Department of Dermatology,the First Hospital of Shanxi Medical University from January 2008 to April 2018 were collected and retrospectively analyzed.Results:There were 32 patients with Severe drug eruption,including 15 males and 17 females.The male to female ratio was 1:1.13 and the age was(45.19 21.01)years old.Common sensitizing drugs include anti-epileptic drugs,antibiotics,Chinese medicine/Chinese patent medicines,and antipyretic analgesics.The incubation periods are 22.44 13.97,5.15 4.22,5.67 5.51,and 5.51 16.97 days,respectively.Classification: 20 cases of Stevens-Johnson syndrome(62.50%),8 cases of toxic epidermal necrolysis(25.00%),3 cases of drug-induced exfoliative dermatitis(9.38%),1 case of drug hypersensitivity syndrome(3.13%).Among the accompanying symptoms,the incidence of mucosal damage and fever was the highest(75.00%),followed by liver damage(56.25%).Two patients(6.25%)with toxic epidermal necrolysis died and the rest were discharged.Hormone combined with Intravenous Immunoglobulin treatment of severe drug eruption in the rash control time,the maximum dose of hormones,the cumulative dose of hormones in the control of rash,the total dose of hormones,etc.are lower than the hormone group alone(P<0.05).Conclusion: 1.Age of predisposition of Severe drug eruption is 8-79 years old,but severe polymorphic erythema drug eruption is mainly young and middle-aged.The toxic epidermal necrolysis is mainly caused by the elderly.2.There are many kinds of drugs causing severe drug eruptions.Common sensitizing drugs are antiepileptic drugs,antibacterial drugs,traditional Chinese medicines/Chinese patent medicines,antipyretic analgesics and etc,and single-sensitive drugs are most common with carbamazepine.3.Severe drug eruption clinical classification is the most common type of Stevens-Johnson syndrome,followed by toxic epidermal necrolysis,and drug-induced exfoliative dermatitis and drug hypersensitivity syndrome are rare.4.Anti-epileptic drugs(especially carbamazepine)have the longest incubation period of up to 40 days.Followed by antibacterial drugs is Chinese medicine / proprietary Chinese medicine.5.The clinical manifestations of severe drug eruptions are complex and diverse.Mucosal damage,fever,and multiple organ damage(especially liver damage)are the most common.Kidney and heart damage are also not uncommon.Toxic epidermal necrolysis is more likely to be associated with mucosal damage.6.In Early stage,sufficient glucocorticoids is the first choice for the treatment of severe drug eruption,and combined intravenous gamma globulin treatment is more sffective.